Barbara Metcalf discovered that her snoring could result in some very serious health issues if untreated

Napping on the train last summer I was suddenly woken by the sound of a loud snore. It was deep and resonant and ended in a huge snort.

I opened my eyes to see my family looking shocked before bursting into giggles. I came to properly, in time to see a smartly dressed businesswoman gather up her laptop and move down the carriage.

In that moment I realised it was I who had been snoring - great, shattering blasts worthy of a navvy after downing 12 pints of beer.

To make matters worse, we were in the Quiet Zone, where the only sound allowed was the train's movement. Everyone around me would have heard. It was mortifying.

I had always hoped that I was naturally feminine and alluring while sleeping. But over the past ten years my partner, Peter, has repeatedly said I snored - sometimes when I was taking a nap, sometimes in the middle of the night (when my snores had woken him for the umpteenth time). I'd always thought he was joking and would deny it - or blame the dog Zac, a Cavalier King Charles, who sleeps in our room.

When my youngest daughter, Izzy, used to creep into our bed for a quick cuddle before getting ready for school, she had often shaken me awake and told me I was snoring. I blamed her dad. But the train incident seemed to confirm they were right and I'd been in denial.

It was understandable, really; I've always thought snoring was the result of over-indulgence, particularly of beer and cigarettes and fatty foods. As I don't drink alcohol, or smoke or eat fatty foods, why would I snore?

But snoring wasn't the only problem - increasingly over the past five years I have been falling asleep during the day, too. At the computer screen, in the cinema, in front of the TV. I have even been nodding off while on the phone - particularly if put on hold - and during conversations with my family, sometimes with a cup of tea in my hand. I once found my daughter stabbing me awake with a pencil during a discussion about her A-level choices.

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I did wonder if I had something seriously wrong. But then, in my more sensible moments, I thought I was just tired because I have a busy lifestyle.

Yet a couple of months ago I discovered that my snoring could result in some very serious health issues if untreated.

Snoring and unexplained daytime sleepiness - either on their own or combined - may amount to nothing. But the two of them, together with my increasing weight, and my age (over 50) indicated my problem was likely to be OSA - Obstructive Sleep Apnoea - essentially, interrupted breathing during sleep.

When we sleep, our airways naturally relax and narrow. With sleep apnoea, the muscles and soft tissues around the airways relax and collapse so much they cause a blockage to the airway (the snoring is caused by the air being forced through a narrower space).

But if the airway becomes completely blocked you can actually stop breathing for ten seconds or more until you gasp or choke. It's then that the brain starts the breathing process again.

'Although you might not fully wake up, your brain will wake each time there is a blockage, and that causes terrible tiredness during the day,' explains Adrian Williams, professor of sleep medicine at King's College London.

The long-term effect of obstructive sleep apnoea if not treated is frightening - it's linked to high blood pressure, type 2 diabetes, heart attacks and strokes. It can also lead to weight gain.

As Professor Williams, who is also the sleep adviser to the British Lung Foundation, explains: 'Hormones that drive the appetite are altered by lack of sleep. One hormone that signals satiety is reduced, while the one that signals appetite is increased - this can lead to weight gain, which can only make OSA worse.'

Being excessively tired as a result of having your sleep repeatedly disrupted as you stop breathing during the night carries risks, too. 'There is some research that shows that drivers who have OSA are six times more likely to have road accidents than those who don't,' says Professor Williams.

Yet the condition does not always get picked up as quickly as it should. The British Lung Foundation believes 80 per cent of people with the condition are undiagnosed.

One problem, according to the British Snoring and Sleep Apnoea Foundation, is a reluctance by women to admit they snore. There's also the chance a GP will confuse obstructive sleep apnoea with another condition.

The long-term effect of obstructive sleep apnoea if not treated is frightening, says Barbara

My sleep apnoea was only confirmed by accident. Three months ago, I was admitted to hospital for an emergency operation on an infected gall bladder. I hadn't seen it coming at all.

But a second shock awaited me. During the operation the anaesthetist had come across a problem with my airway, and when I came to he suggested I might have sleep apnoea when I'd refused to believe I even snored.

To be sure of the diagnosis while I was in hospital, I was given a wristwatch-like device to wear with a monitor attached to my finger to check my oxygen levels and pulse rate during sleep. Two weeks later, and by then an outpatient, it was confirmed I had sleep apnoea.

The test revealed I stopped breathing 14 times an hour, for seconds each time during the night. That sounded pretty shocking to me, but I am told that some people will stop breathing twice as many times as that, for as long as two minutes each time.

My snoring was 'the start of the journey', says Professor Williams. Snoring occurs when soft tissues, for example in the nasal passages, the tonsils, tongue or the uvula - the bit that dangles between your tonsils - vibrates.

This can progress to obstructive sleep apnoea because snoring damages the muscles in the throat, causing them to weaken and making tissue more likely to collapse and block the airway.

There are a variety of causes of OSA - being overweight puts you at risk (the obesity epidemic has led to a rise in the number of confirmed cases), although slim people can also get it.

The condition is more common in middle-aged men - around 7 per cent of men get it - mainly because they have thicker necks and so have more tissue around their airways.

Yet 3 per cent of women are also
affected. Women become more likely to snore and develop OSA after the
menopause, because of lower levels of oestrogen and progesterone, which
help protect and support muscles around the airways during child-bearing
years. Some people are also born with large amounts of soft tissue
around the airway.

'Continuous Positive Airway Pressure. It keeps the upper airway open by providing a constant flow of air delivered via the mask as you sleep'

Fortunately, there is an effective treatment in the form of a mask attached to a machine that now takes pride of place on my bedside table.

It's called CPAP - Continuous Positive Airway Pressure. It keeps the upper airway open by providing a constant flow of air delivered via the mask as you sleep.

According to Professor Williams, when used properly the device can help, but he admits that around 25 per cent of patients don't continue to use them because they find them too difficult or uncomfortable to wear. 'Some patients will take them off in the night, others just can't use them,' he says.

And so I approached my appointment for fitting the mask with some trepidation. I had heard from a couple of people recently diagnosed and they had hated it, finding the pressure of air too forceful. I was also warned I might find it claustrophobic, or uncomfortable. Some patients panic.

But I felt no panic at all. Admittedly, it is an odd sensation wearing such a tight-fitting object over your nose and mouth - I look a bit like a Top Gun pilot in it. The air flow can be a shock, but I've been using it for three weeks and, although I have no trouble getting to sleep wearing it, I do wake in the night because it makes me hot.

Will I have to use the mask for ever? I was told perhaps. If I lose weight, the symptoms might reduce, but there is no guarantee.

On the plus side, I'm no longer falling asleep during the day and Peter is enjoying not being woken up by my snores, too.